12.6m deaths linked to unhealthy environments

• Chemical exposures, climate change, others contribute to more than 100 diseases, injuries
• Stroke, heart disease, cancers, chronic respiratory disease cause 75% of total fatalities
• As mortalities from infectious diseases such as diarrhea, malaria have declined
• Recommends reducing use of solid fuels for cooking, increasing access to low-carbon energy technologies

A new estimates released yesterday by the World Health Organisation (WHO) suggest that 12.6 million people died as a result of living or working in an unhealthy environment in 2012 – nearly one in four of total global deaths.

According to the second edition of the WHO report, “Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks,” environmental risk factors, such as air, water and soil pollution, chemical exposures, climate change, and ultraviolet radiation, contribute to more than 100 diseases and injuries.

It reveals that since the report was first published a decade ago, deaths due to non-communicable diseases (NCDs), mostly attributable to air pollution (including exposure to second-hand tobacco smoke), amount to as much as 8.2 million of these deaths.

The report reads: “NCDs, such as stroke, heart disease, cancers and chronic respiratory disease, now amount to nearly two-thirds of the total deaths caused by unhealthy environments.

“At the same time, deaths from infectious diseases, such as diarrhoea and malaria, often related to poor water, sanitation and waste management, have declined. Increases in access to safe water and sanitation have been key contributors to this decline, alongside better access to immunization, insecticide-treated mosquito nets and essential medicines.”

The report emphasizes cost-effective measures that countries can take to reverse the upward trend of environment-related disease and deaths. These include reducing the use of solid fuels for cooking and increasing access to low-carbon energy technologies.

WHO Director-General, Dr. Margaret Chan, said: “A healthy environment underpins a healthy population,” says,. “If countries do not take actions to make environments where people live and work healthy, millions will continue to become ill and die too young.”WHO Director, Department of Public Health, Environmental and Social Determinants of Health, Dr. Maria Neira, said: “There’s an urgent need for investment in strategies to reduce environmental risks in our cities, homes and workplaces.

“Such investments can significantly reduce the rising worldwide burden of cardiovascular and respiratory diseases, injuries, and cancers, and lead to immediate savings in healthcare costs.”

According to the report, environmental risks take their greatest toll on young children and older people, the report finds, with children under 5 and adults aged 50 to 75 years most impacted. Yearly, the deaths of 1.7 million children under five and 4.9 million adults aged 50 to 75 could be prevented through better environmental management. Lower respiratory infections and diarrhoeal diseases mostly impact children under five, while older people are most impacted by NCDs.

Regionally, the report finds, low- and middle-income countries in the WHO South-East Asia and Western Pacific Regions had the largest environment-related disease burden in 2012, with a total of 7.3 million deaths, most attributable to indoor and outdoor air pollution.

Low- and middle-income countries bear the greatest environmental burden in all types of diseases and injuries, however for certain NCDs, such as cardiovascular diseases and cancers, the per capita disease burden can also be relatively high in high-income countries.

Looking across more than 100 disease and injury categories, the report finds that the vast majority of environment-related deaths are due to cardiovascular diseases, such as stroke and ischaemic heart disease: stroke – 2.5 million deaths annually; ischaemic heart disease – 2.3 million deaths annually; unintentional injuries (such as road traffic deaths) – 1.7 million deaths annually; cancers – 1.7 million deaths annually; chronic respiratory diseases – 1.4 million deaths annually; diarrhoeal diseases – 846 000 deaths annually; respiratory infections – 567 000 deaths annually; neonatal conditions – 270 000 deaths annually; malaria – 259 000 deaths annually; and intentional injuries (such as suicides) – 246 000 deaths annually

The report cites proven strategies for improving the environment and preventing diseases. For instance, using clean technologies and fuels for domestic cooking, heating and lighting would reduce acute respiratory infections, chronic respiratory diseases, cardiovascular diseases and burns. Increasing access to safe water and adequate sanitation and promoting hand washing would further reduce diarrhoeal diseases.

According to the report, tobacco smoke-free legislation reduces exposure to second-hand tobacco smoke, and thereby also reduces cardiovascular diseases and respiratory infections. Improving urban transit and urban planning, and building energy-efficient housing would reduce air pollution-related diseases and promote safe physical activity.